Interactive Metronome

Michael Morris with his soccer accolades

What Is Interactive Metronome?

Interactive Metronome (or IM) is a computer based program where a patient with SPD attempts to clap to the beat of auditory sounds sent by a computer program over a large pair of headphones. The computer then measures to the millisecond how close the patient is to matching the beat. Later, feet tapping and hand clapping that involves crossing the midline are added. The system uses electronic sensors that can be activated by pressing them with a hand or stepping on them. The sensors for the hands are often small buttons that have Velcro on the back, allowing them to be strapped to the hand or placed onto a wall and pressed. There are also sensors that can be found in a strip taped to the floor in order to activate it by stepping down on it.

Interactive Metronome generally takes place over a 15 session period, and is often available at a private Occupational Therapy clinic. According to the official Interactive Metronome website,, the protocol has been used since the early 1990's to treat patients with learning disabilities and neurological disorders like Sensory Processing Disorder, Autism Spectrum Disorder, and Attention Deficit/Hyperactive Disorder.

What Improvements Can We Expect?

The Interactive Metronome is intended to help work at treating children and adults with any number of neurological issues, including:

  • Improved coordination and internal timing
  • Longer attention span and impoved focus and concentration
  • More effecient language processing skills, also improving reading and math skills
  • Better behavioral regulation (lowered impulsivity and aggression)
  • Improved strength, stamina, and endurance
  • Greatly improved motor skills
  • Better motor planning and motor sequencing
  • Increased balance and a more smoothly developed gait and posture

Remember though, that these are just a few of the improvements you may see when using this amazing protocol. There are a whole host of other areas you might see improving during this time, as treating some issues often helps to treat problems in other areas. Remember, it is all connected, in the end. Also, as with any other treatment protocol, results will vary. Not every child or adult will respond to the Interactive Metronome with as possitive results as others. However, from our experiences, this is generally one of the most effective treatments for SPD available for your use.

Have You Tried this Program?

I have done this program with my son, who was diagnosed at the age of three with one of the severest forms of Sensory Processing Disorder our developmental pediatrician had ever seen. He was initially thought to be Autistic, but the diagnosis was later refined to just SPD and Dyslexia. His processing deficits were in all the categories. He had Sensory Modulation Disorder (includes over responsivity, under responsivity, and sensory seeking), Sensory Based Motor Disorder (includes dyspraxia and postural disorder) and Sensory Discrimination Disorder (includes vision, hearing, touch, taste, smell, position/movement).

"his senses were completely dysfunctional."

In other words, his senses were completely dysfunctional. Screamed through every day and night. Choked on all foods, head banged, vomited, never slept. Couldn't talk, and so much more, even affecting his heart rate, and respiration, bowels and bladder function. Just, really a mess, and the saddest, most miserable child I had ever seen. Some of this may be familiar to you.

When We First Tried the Metronome

When he was six, we tried to do the Interactive Metronome, but his sequencing, timing, auditory and visual processing were still too severe. He couldn't even do the Training for the IM, because he was completely off the beat. Way off the beat. He was, saying, "I'm doing it Mom!" and he honestly believed he was. Uhhh... Not yet.

How We Helped Get Him Started

We worked on visual spatial issues with strong home activities, and auditory activities. We continued to do activities to address timing and sequencing at home and in the clinic. I bought a simple home Metronome, and we did activities daily, making it fun. Marching to the beat. Clapping, singing, exercising to the beat. Sleeping to a slow beat. Reading and writing to the beat. And a year later, we tried again, and he was just barely good enough, improved enough, to do the program. And so we began. Yes, it was yet another therapy for him, but each one can be a piece of their puzzle. Each one can help a bit here, a bit there, and we watch it all integrate.

By now, IM had come out with what they call the "children's version". Ok. They added a visual component. I still feel they can improve on this software for children considerably, but we do what we can with what we have. He didn't like it. He grumbled, and groaned, and became avoidant. I knew this kid, so I offered rewards for completing each session (he fell for the Milkshake). I made him a visual chart, so he could X out each session and count how many were left. Then, he saw that he was beginning to beat his own scores, and he was off! No one had to encourage him then.

During the Program...

Interactive Metronome is normally a 15 session program. Although some of these kids seem to plateau around the half way mark, as it's getting more challenging, and they are getting tired of it. They seem, at least the 50 or so I observed during the three years I was working at an OT clinic, to regress for a few sessions, then come back stronger. I knew my son, and if he regressed he was likely to give up.

"They seem, at least the 50 or so I observed during the three years I was working at an OT clinic, to regress for a few sessions, then come back stronger."

At the half way point, his scores were becoming surprisingly high, so I insisted on a two week break. During this break, we did swimming lessons, and went fishing a lot. We gave him increased proprioceptive input (Heavy muscle movement activities). Let him settle in to this new sequencing and timing going on. Now, this was an arbitrary decision of mine, and not in the IM protocol. In my opinion, while doing so many forms of intensive therapy with these kids, one after another, our children's brains need an occasional break to be able to fully integrate new skills and patterns it is learning. A pause, if you will. Maybe the child does too. Maybe I did, I don't know, he just seemed to do better when we took a short break after significant gains, now and then.

When We Resumed

When we came back from our break, he resumed happily, knowing he was on the downhill stretch. His scores were higher and higher, breaking his own records in every single session. He could now sequence to tie his shoes, auditory processing improved. Visual tracking issues improved. He started hitting a baseball with such accuracy we were stunned, and I cried. We are still amazed by that one. He plays soccer, and the previous season, he never once could kick that ball. The season after doing IM, he was picked out of 160 kids to be on the All Star Team. Visual/spatial, timing, sequencing, math and maybe most importantly his confidence soared. It helped his reading, as this can, but he needed more support due to his Dyslexia.

"He plays soccer, and the previous season, he never once could kick that ball. The season after doing IM, he was picked out of 160 kids to be on the All Star Team."

We were seeing skills he never had, and it was dramatic and sudden, with each session. I also saw improvement in Executive Functioning and planning. Again, the times it seemed irritating to him, and he was feeling agitated, I decreased environmental sensory overload, and increased his sensory activities to counter that. That worked for us.

On the last day, the final assessment, he scored in the gifted range, and had the highest score our clinic had seen in any of the children they had treated. IF, 5-10 years from now, he desires to play sports professionally, or wants any occupation that requires precision and great accuracy in timing, and sequencing, I wouldn't hesitate to repeat this program.

Would You Recommend This Therapy?

If you feel that your child is able to do it, and his therapists/doctor agree it is the right time, then yes I absolutely recommend this therapy. It was very beneficial to my child, and many I have witnessed. I have also seen children who became too distressed and could not do it. Those were few.

You are the expert on your child. You know your child best and what he or she can handle. And when. And I think we need to be assertive about that in their therapy. When to challenge and support, and when to let them make choices and take a break. It's a balance.

— Written by Michelle Morris, December 2005
Edited by Daniel Travis, December 2009

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